Professional Practice, Rehabilitation, and Patient Education
Rehabilitation principles
Rehabilitation begins on admission: positioning, early mobilization, range of motion, then progressive strengthening, then functional training and gait. Weight-bearing orders must be followed exactly: non-weight-bearing, toe-touch, partial, weight-bearing as tolerated, full. Fit aids to the patient: crutches sit 2–3 finger widths below the axilla with elbows flexed about 30 degrees, and body weight is carried on the hands and forearms, never in the axilla, to avoid axillary nerve compression. A cane is generally used on the unaffected side for an opposite lower-limb problem, with the handle at the greater trochanter. Walkers are adjusted to the hip or wrist crease with elbows slightly flexed.
Stairs and transfers
"Up with the good, down with the bad": ascend leading with the stronger leg, descend leading with the crutch or affected leg. Teach sit-to-stand using the stronger leg and armrests, and reinforce hip precautions after posterior total hip arthroplasty (no flexion past 90 degrees, no adduction past midline, no internal rotation).
Education and professional practice
Use teach-back to confirm understanding, involve family, and match materials to health literacy, language, and culture. Documentation must be factual and objective. Ethical practice includes advocacy, informed consent, confidentiality, and reporting suspected abuse. Discharge planning starts early: home safety, durable medical equipment, follow-up, and red flags to report - fever, worsening pain, drainage, numbness, calf pain, chest pain, or dyspnea.
Rule of thumb
Teach the red flags as explicitly as the exercises; patients who know what to report are safer at home.